Myocardial infarction with normal coronary arteries in double heterozygous sickle-cell disease

Robard, I.; Mansencal, Nicolas; Soulat, Gilles; Deblaise, Julien; Mahmoud, Rami El; Dubourg, Olivier

doi:10.1016/j.ijcard.2014.11.165

Cited by 5 publications

(6 citation statements)

References 9 publications

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“…7 Macroscopic and microscopic elements consistent with acute myocardial infarction without coronary abnormality have been found in several autopsy studies of patients with SCD. [28][29][30][31][32][33] Altered myocardial perfusion reserve has been demonstrated in these patients by different techniques. 34 Therefore, it can be assumed that during vaso-occlusive crises, acute myocardial ischaemia may appear due to the conjunction of anaemia, coronary microvascular obstruction, tachycardia, pain-related adrenergic stress and potentially oxidative-related endothelial damage during episodes of ischaemia-reperfusion.…”

Section: Discussionmentioning

confidence: 99%

Left ventricular global longitudinal strain and acute myocardial injury in patients with sickle cell disease admitted to the intensive care unit for vaso‐occlusive crisis

Roger,

Denormandie,

Gobe

et al. 2024

Br J Haematol

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SummaryIn patients with sickle cell disease (SCD), SCD‐related cardiomyopathy may be partly due to repeated ischaemic events related to sickling during vaso‐occlusive crises, but few clinical studies support this hypothesis. We evaluated the incidence of acute myocardial ischaemia during vaso‐occlusive crises as assessed by the left ventricular global longitudinal strain (LVGLS) and high‐sensitive cardiac troponin T (hs‐cTnT). We included adult patients with SCD admitted to the intensive care unit (ICU) for vaso‐occlusive crisis. We collected hs‐cTnT and measured LVGLS with echocardiography at admission (day 1), day 2, day 3 and ICU discharge. Among 55 patients included, considering only the first hospitalization of patients admitted several times, 3 (5%) had elevated hs‐cTnT at ≥1 time point of the ICU stay. It was ≤2 times the upper limit of normal in two of these patients. LVGLS was altered at ≥1 time point of the ICU stay in 13 (24%) patients. Both hs‐cTnT and LVGLS were abnormal at ≥1 time point of the hospital stay in 2 (4%) patients. Acute myocardial injury as assessed by troponin elevation and LVGLS impairment was a rare event during vaso‐occlusive crises.

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Section: Discussionmentioning

confidence: 99%

Left ventricular global longitudinal strain and acute myocardial injury in patients with sickle cell disease admitted to the intensive care unit for vaso‐occlusive crisis

Roger,

Denormandie,

Gobe

et al. 2024

Br J Haematol

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“…21 Chronic recurrent vaso-occlusive episodes also subject cardiac myocytes to repeated ischemic insults even in the absence of atherosclerotic coronary artery disease. 22,23 These ischemic episodes are a possible mechanism of valvular pathology in SCD due to the involvement of papillary muscles leading to secondary valvular insufficiency.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of non-rheumatic valvular heart disease in patients with sickle cell disease: insights from the National In-Patient Database in 2016 and 2017

Quelal

Torres

Shahi

et al. 2023

Journal of Investigative Medicine

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Sickle cell disease (SCD) life expectancy has increased in high-income countries, approaching the fifth decade in the United States. Aging in SCD has raised concerns about chronic organ damage due to adaptative and maladaptive cardiac remodeling. This study aims to assess the prevalence and predictors of non-rheumatic valvular heart disease (NRVHD) in SCD patients using the United States National Inpatient Sample database from 2016 and 2017. We conducted a weighted analysis on SCD patients during their index hospitalization. We obtained the prevalence of NRVHD and calculated adjusted odds ratios to identify the associated demographic, social, and clinical characteristics using multivariable logistic regression. We identified 192,460 SCD admissions during 2016 and 2017. Of them, 2450 (1.3%) had NRVHD. Mitral insufficiency (MI) was the most common NRVHD present in 52% of the cases. Mitral valve prolapse represented 12.4%, while aortic stenosis and aortic insufficiency in 10.8% and 12.7%, respectively. Right-sided NRVHD had a lower prevalence, with 17.1% of patients having tricuspid insufficiency (TI) and 6.3% pulmonary insufficiency. There were no cases of mitral, tricuspid, or pulmonary stenosis. Characteristics associated with the presence of NRVHD in SCD were secondary pulmonary hypertension, congestive heart failure, chronic kidney disease, and female sex. NRVHDs, especially MI and TI, are comorbidities in SCD. Literature is scarce on this topic. The predictors found for its occurrence could help address modifiable factors that can positively affect patients with SCD who, due to the natural history of the disease, are at risk of developing NRVHD.

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“…2 Monate alter kardiologischer Befund mit Echokardiographie vor, hier werden eine leicht-bis mittelgradig reduzierte linksventrikuläre sowie eine gute rechtsventrikuläre Pumpfunktion beschrieben, aufgrund der LV-Dilatation zeigt sich eine Mi-tralklappeninsuffizienz°II. Trotz einer ausgeprägten Anämie mit einem präoperativ gemessenen Hämoglobin(Hb)-Wert von 3 Verschlusses potenziell zu Myokardinfarkten kommen [5]. Bemerkenswert ist dabei, dass die SCD selbst auch ein Risikofaktor für das Entstehen einer Atherosklerose ist [6].…”

Section: Anamneseunclassified

“…Aufgrund von Adaptation und der Tatsache, dass das krankhafte HbS eine geringere Sauerstoffaffinität als HbA hat, ist die Gewebeoxygenierung tatsächlich jedoch oft besser als erwartet. Dennoch kann es trotz Fehlens einer tatsächlichen arteriellen Stenose oder gar eines Verschlusses potenziell zu Myokardinfarkten kommen [ 5 ]. Bemerkenswert ist dabei, dass die SCD selbst auch ein Risikofaktor für das Entstehen einer Atherosklerose ist [ 6 ].…”

Section: Diskussionunclassified

Herzfrequenzabhängige EKG-Veränderungen bei einem Patienten mit schwerer Sichelzellanämie

2021

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Myocardial infarction with normal coronary arteries in double heterozygous sickle-cell disease

Cited by 5 publications

References 9 publications

Left ventricular global longitudinal strain and acute myocardial injury in patients with sickle cell disease admitted to the intensive care unit for vaso‐occlusive crisis

Left ventricular global longitudinal strain and acute myocardial injury in patients with sickle cell disease admitted to the intensive care unit for vaso‐occlusive crisis

Prevalence and predictors of non-rheumatic valvular heart disease in patients with sickle cell disease: insights from the National In-Patient Database in 2016 and 2017

Herzfrequenzabhängige EKG-Veränderungen bei einem Patienten mit schwerer Sichelzellanämie

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